In this issue of Headache, we publish the Migraine Action Plan (MAP).
All patients with migraine should have a MAP. This is a management plan developed by you (the patient’s healthcare provider) and is a communication tool between you, your patient, and other healthcare providers. It includes information about home rescue strategies for when your patient’s migraines occur, guidelines for when to go to the Emergency Department, and treatment suggestions for Emergency Department providers.
The MAP includes four parts:
In Headache Information, you identify the specific headache diagnosis along with listing any daily medications that you recommend your patient take for headache prevention.
In Home Rescue Plan, you can select from a variety of home rescue management strategies and identify for your patients what they should take when they experience a migraine.
In Hospital Rescue Plan, your patient will have guidelines for when to seek urgent or emergent care. In this part, you can also select treatment options that you suggest your patient receive in the Emergency Department, should they be diagnosed with a migraine exacerbation in the Emergency Department.
In Medications to Avoid, there is a list of medications commonly known to exacerbate migraines.
The MAP includes treatment options reflected in the American Academy of Neurology Practice Parameters1 and the American Headache Society (AHS) guidelines on acute migraine treatment in the Emergency Department.2 Additionally, we incorporated feedback from headache specialists through two national committees: the AHS Emergency Department, Inpatient and Refractory Special Interest Section and the AHS Academic Headache Program Directors Group.
Acknowledgments
Funding: Dr. Mia Minen is a recipient of the American Academy of Neurology-American Brain Foundation Practice Research Training Fellowship which provides salary support for time to conduct research.
Footnotes
Conflicts of Interest: None.
Contributor Information
Addie M. Peretz, Stanford University, Stanford, CA, USA.
Mia T. Minen, New York University, Langone Medical Center, New York, NY, USA.
Robert Cowan, Stanford University, Stanford, CA USA.
Lauren D. Strauss, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
REFERENCES
- 1.Silberstein SD; for the US Headache Consortium. Practice parameter: Evidence-based guidelines for migraine headache (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000;55:754–762. [DOI] [PubMed] [Google Scholar]
- 2.Orr SL, Friedman BW, Christie S, et al. Management of adults with acute migraine in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies. Headache. 2016;56:911–940. [DOI] [PubMed] [Google Scholar]